Engineering Health Information Systems

Canada Health Infoway (CHI) has been funded by the Canadian government with $2.1 billion since 2001 to foster the development of a pan-Canadian EHR infrastructure. CHI’s mandate has been to “collaborate[s] with Canada’s provinces and territories, health care providers and technology solution companies to implement private and secure health information systems.” (see CHI’s latest report to the public.) The latest report contains a risk management framework containing an analysis for different types of risks, including financial risks (funding), adoption risks and security and privacy risks. It’s noteworthy that safety risks do not appear at all. In fact, the safety aspect is not addressed in the entire report, apart from general conjectures that eHealth technologies will improve patient safety. As mentioned in my previous blog, there is significant indications that this is not necessarily so. The absence of making safety a priority in the pan-Canadian summary care record architecture standards may very well become a major problem down the road. (see recent commentary of Ross Anderson in BMJ, who believes that summary care records will do more harm than good.) The failure of addressing safety in pan-Canadian EHR standards as a primary objective is also in stark contrast with the objectives of regulators (Health Canada, FDA), who are primarily concerned about safety of EHR software. It it time to redefine CHI’s mandate to include safety as another quality objective, next to privacy and security?